POS0544 REMOTE MONITORING TOOLS IN RA PATIENTS: FACIT-FATIGUE AND HAQ
Authors: E. Grau García, P. Muñoz Martinez, L. Mas Sanchez, C. Riesco Barcena, A. V. Huaylla Quispe, S. Leal Rodriguez, C. Pávez Perales, M. De la Rubia Navarro, I. Cánovas Olmos, J. J. Fragío Gil, L. Gonzalez Puig, J. Ivorra Cortés, I. Martínez Cordellat, C. Nájera Herranz, R. Negueroles Albuixech, J. E. Oller Rodríguez, F. Ortiz-Sanjuán, E. Vicens Bernabeu, J. A. Román Ivorra
Journal: Annals of the Rheumatic Diseases (2022)

Background The need to avoid the transmission of COVID19 infection has forced to promote teleconsultations for rheumatic diseases follow-up. However, remote monitoring for rheumatic diseases which require clinical examination, as rheumatoid arthritis (RA), may affect to the evaluation of clinical activity, including the biological therapies follow-up. Due to that, count on tools as Patient Reported Outcomes (PROs) could help the remote monitoring of patients when it is not advisable their physical presence in health centers, being a great help in RA control. Objectives We aim to assess the association among the tiredness, disability and pain perception with the clinical activity in RA patients. Methods We performed a prospective observational study of three months of follow-up in RA patients (ACR/EULAR 2010) who are newly on biological or anti-JAK therapy. A basal visit and 1, 3 months follow-up visits were conducted. We analyzed changes during follow-up in the PROs parameters reported by patients through FACIT-fatigue and HAQ questionnaires, as well as pain VAS (0-10). Moreover we measured clinical activity through Das28, Das28-CRP, SDAI and CDAI index. Results We included 60 patients (83.3% female), with a mean age of 55 (13) and mean disease evolution of 13 (11) years. At the basal visit, 55% of them exhibited increased levels of CRP and the 48.3% of ESR, showing moderate or high clinical activity the 83.3% of the total patients. 39 patients started anti-JAK therapy and 21 with TNF-α inhibitors. The 33.34% of patients were under monotherapy, and the 46.67% previously have been treated with biological therapy. The 77.36% of the total number of patients was on the biological therapy at 6 months of follow-up, while the 22.64% discontinued at 6 months of follow-up (9 due to inefficacy and 3 due to adverse effects). 48 patients continued the treatment in the 6 months after, and 12 patients discontinued due to ineffectiveness or drug intolerance. Clinical activity, fatigue, disability and pain perception are shown in Table 1. Table 1. Variable VISIT 0N=60 VISIT 1N=57 VISIT 3N=45 Mean (SD) Mean (SD) Mean (SD) Pain VAS 6 (2) 4 (3) 5 (3) HAQ 1.33 (0.61) 1.06 (0.64) 1.06 (0.69) FACIT-fatigue 25.52 (12.19) 31.03 (12.9) 32.76 (12.46) DAS28 4.78 (1.2) 3.6 (1.33) 3.54 (1.44) DAS28-CRP 4.31 (1.06) 3.19 (1.14) 3.05 (1.28) SDAI 22.72 (9.88) 13.58 (8.58) 12.97 (9.32) CDAI 21.75 (9.62) 12.88 (7.96) 12.36 (9.11) Using a mixed linear regression model the association among the fatigue, disability and pain perception with clinical activity was conducted, corrected by age, smoking habits, time of disease evolution, BMI, previous biological/anti-JAK therapy administration and current dose of steroids. We observed a significant association among clinical activity and fatigue (P&lt;0.001), disability (P&lt;0.001) and pain perception (P&lt;0.001). The statistical analyses showed a significant association where a high fatigue is increased in cases with high pain perception (P&gt;0.001) and high number of swollen joints (P=0.002), but not in high levels of CRP and ESR. Fatigue was higher in those cases whom discontinued treatment (P=0.044) regardless of which therapy was chosen. No effect of age, time of disease evolution, steroid dose, BMI or previous therapy and smoking habits in the PROs values was observed. Conclusion PROs would be helpful in the disease control in those cases where a remote monitoring is needed, since HAQ or FACIT-FATIGUE index showed a significant association with clinical activity index in RA. Because of its ease for shipping and handling by the health professional, PROs could be a useful tool in the disease control. Its implementation in the remote monitoring of RA patient, as has been the case of Covid19 pandemic, results in an improvement of the clinic evaluation of RA patient, due to required information to clinical management is reported, avoiding presence consultation in those situations when it is required. Disclosure of Interests None declared.